Clinical study on evaluation of various parameters in chronic lower limb ischemia

Abstract

Aim: To study the modes of presentation of chronic lower limb ischaemia, co-morbid conditions like diabetes, smoking and hypertension and assess the treatment modalities with respect to outcome. Materials and methods: This study was conducted by random selection of 50 cases with chronic lower limb ischemia admitted to surgical wards. This was a cross sectional and observational study of 50 cases diagnosed with chronic lower limb ischemia, done for a period of 6 months. Results: The commonest age group affected by TAO is between 31 and 40 yrs and those affected with Atherosclerosis is above the age of 60 yrs. Almost all patients with TAO had a history of chronic smoking and 61 % of Atherosclerosis patients had a history of smoking. In the present study, all the cases of PAD presented with ischemic claudication and rest pain as common symptoms, while gangrene and ischemic ulcer were the other predominant symptoms in 80 % and 40% of cases respectively. 40 (80%) of the patients in this study presented at a late stage in the disease process, with gangrenous changes, leaving minimal options for salvaging the affected limb. The level of amputation was below knee in 42% and above knee in 58% cases. The patients who continued to smoke had aggravation of symptoms. Post operatively 24 had uneventful recovery, 21 required secondary suturing, 3 required revision amputation at a higher level. 2 cases were managed conservatively. Conclusion: Lumbar Sympathectomy had helped in Improvement of rest pain noted in 67% of cases, healing of ulcer in 50%. The level of amputation was below knee in 42% and above knee in 58% cases.